Medicare Part D coverage · avatrombopag · RxCUI 2045958
avatrombopag 20 MG Oral Tablet [Doptelet]
Per the CMS 2026 Part D formulary file, avatrombopag 20 MG Oral Tablet [Doptelet] is covered by 3,242 Medicare Part D plans (64.2% of enrollable products), averaging Tier 4.2, with prior authorization required on 99.5% of covering formularies.
- 64.2%
- Plan coverage
- 3,242
- Plans covering
- T4.2
- Avg tier
- 99.5%
- Prior auth required
What the CMS Formulary Data Shows for avatrombopag 20 MG Oral Tablet [Doptelet]
Per the CMS 2026 Part D formulary file, avatrombopag 20 MG Oral Tablet [Doptelet] (RxNorm concept RXCUI 2045958, generic name avatrombopag) appears on 201 distinct formulary files spanning 3,242 Medicare Part D plan offerings - 64.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to avatrombopag 20 MG Oral Tablet [Doptelet] depends on utilization management as much as tier placement: 99.5% of covering formularies require prior authorization. 0% require step therapy. 32.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,609 Part D beneficiaries filled avatrombopag 20 MG Oral Tablet [Doptelet] in 2023, with total plan-and-beneficiary spending of $96,044,175 and an average per-beneficiary annual cost of $59,691.84. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry avatrombopag 20 MG Oral Tablet [Doptelet] today.
Coverage Details
- Formularies covering
- 201
- Plans covering
- 3,242
- Coverage rate
- 64.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 99.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 32.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,609
- Total spending
- $96,044,175
- Avg per beneficiary
- $59,691.84
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering avatrombopag 20 MG Oral Tablet [Doptelet]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
Show the next 30 plans
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | Yes | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | Yes | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is avatrombopag 20 MG Oral Tablet [Doptelet] covered by Medicare Part D?
Yes, avatrombopag 20 MG Oral Tablet [Doptelet] is covered by 3,242 Medicare Part D plans (64.2% of all Part D formularies).
What tier is avatrombopag 20 MG Oral Tablet [Doptelet] on Medicare Part D plans?
avatrombopag 20 MG Oral Tablet [Doptelet] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does avatrombopag 20 MG Oral Tablet [Doptelet] require prior authorization?
99.5% of Part D formularies require prior authorization for avatrombopag 20 MG Oral Tablet [Doptelet]. Step therapy: 0%. Quantity limits: 32.3%.
How much does Medicare spend on avatrombopag 20 MG Oral Tablet [Doptelet]?
In 2023, total Medicare Part D spending on avatrombopag 20 MG Oral Tablet [Doptelet] was $96,044,175, covering 1,609 beneficiaries. The average spend per beneficiary was $59,691.84.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 1.5 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify] T4.2
- 2 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify] T4.2
- 24 HR asenapine 0.158 MG/HR Transdermal System [Secuado] T4.2
- aripiprazole 400 MG Injection [Abilify] T4.2
- 10 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex] T4.2
- naltrexone 380 MG Injection [Vivitrol] T4.2
Similar prior-authorization rate
- pirfenidone 534 MG Oral Tablet 99.5% PA
- valbenazine 40 MG Oral Capsule [Ingrezza] 99.5% PA
- {7 (valbenazine 40 MG Oral Capsule [Ingrezza]) / 21 (valbenazine 80 MG Oral Capsule [Ingrezza]) } Pack [Ingrezza] 99.5% PA
- {10 (avatrombopag 20 MG Oral Tablet [Doptelet]) } Pack [Doptelet 40 MG Daily Dose Carton] 99.5% PA
- {15 (avatrombopag 20 MG Oral Tablet [Doptelet]) } Pack [Doptelet 60 MG Daily Dose Carton] 99.5% PA
- granisetron 1 MG Oral Tablet 99.6% PA